Department of Cardiothoracic Surgery, The 306 Hospital of PLA, No. 9 An-xiang North Road, Chao-yang District, Beijing, 100101, China.
Department of Cardiothoracic Surgery, The 306 Hospital of PLA, No. 9 An-xiang North Road, Chao-yang District, Beijing, 100101, China.
Int J Surg. 2018 May;53:143-150. doi: 10.1016/j.ijsu.2018.03.034. Epub 2018 Mar 16.
This study was performed to retrospectively evaluate the 10-year overall survival (OS), progression-free survival (PFS), and local control rates of patients with inoperable stage Ia non-small cell lung cancer (NSCLC) who underwent computed tomography (CT)-guided radiofrequency ablation (RFA) in a single center.
Fifty patients with inoperable NSCLC underwent RFA between 2004 and 2016. Thoracic surgeons evaluated the patients and performed RFA under CT guidance. Follow-up CT and positron emission tomography/CT scans were obtained. Local control rates and recurrence patterns were analyzed.
Seventy-three lesions in 50 patients (M:F = 22:28; median age: 73 years; range: 52-82 years) were treated with CT-guided RFA. The mean lesion size was 2.2 cm (range: 1-3 cm). No procedure-related deaths occurred. Low-grade fever was the most common post-ablation complication, with an incidence rate of 36%. The 1-, 2-, 3-, 5-, and 10-year OS rates of patients with Ia NSCLC were 96.0%, 86.5%, 67.1%, 36.3%, and 1%, respectively, and the 1-, 2-, 3-, and 5-year PFS rates were 94.0%, 77.5%, 43.5%, and 10.8%, respectively. The most common pattern of recurrence was local, and 15 patients with recurrence were treated with repeat RFA. Tumor size <2.0 cm was associated with a significantly improved 3-year survival rate of 78.9%.
CT-guided RFA is feasible and well tolerated by inoperable patients with inoperable stage Ia NSCLC.
本研究旨在回顾性评估在一家中心接受 CT 引导下射频消融术（RFA）治疗的不可切除 I 期非小细胞肺癌（NSCLC）患者的 10 年总生存率（OS）、无进展生存率（PFS）和局部控制率。
2004 年至 2016 年间，50 例不可切除 NSCLC 患者接受了 RFA 治疗。胸外科医生对患者进行评估，并在 CT 引导下进行 RFA。进行了随访 CT 和正电子发射断层扫描/CT 扫描。分析了局部控制率和复发模式。
50 例患者的 73 个病灶（M:F=22:28；中位年龄：73 岁；范围：52-82 岁）接受了 CT 引导下 RFA 治疗。病灶平均大小为 2.2cm（范围：1-3cm）。无手术相关死亡。低度发热是最常见的消融后并发症，发生率为 36%。Ia 期 NSCLC 患者的 1、2、3、5 和 10 年 OS 率分别为 96.0%、86.5%、67.1%、36.3%和 1%，1、2、3 和 5 年 PFS 率分别为 94.0%、77.5%、43.5%和 10.8%。最常见的复发模式是局部，15 例复发患者接受了重复 RFA 治疗。肿瘤大小<2.0cm 与显著提高的 3 年生存率（78.9%）相关。
CT 引导下 RFA 对不可切除的 I 期 NSCLC 患者是可行的，且患者耐受性良好。
